Resilience following chronic disability: a longitudinal study after the onset of spinal cord injury

Abstract

Background: The objective of this project is to gain a thorough understanding of resilience and the adjustment process following the onset of spinal cord injury (SCI). The specific aims are 1) to identify subgroups across indicators of well-being and mental health at rehabilitation discharge, 2) to determine the trajectories of well-being and mental health following disability onset, and 3) to test an adjustment model to investigate the mechanism underlying adjustment to SCI. Methods: The project is embedded within the longitudinal Swiss Spinal Cord Injury Cohort Study (SwiSCI). Currently, around 170 newly injured patients of one of the four Swiss SCI rehabilitation centres have completed questionnaires assessing mental and physical health, well-being and other psychosocial factors during first rehabilitation. We will use exploratory latent profile analysis to identify the subgroups across the adjustment indicators, apply latent growth mixture modeling to detect the trajectories, and structural equation models to test the adjustment mechanism. Expected results: We expect 1) to identify at least three different subgroups at rehabilitation discharge (resilient, vulnerable, average copers), 2) to find between 3 and 5 different trajectories for mental health and well-being, and 3) to find a direct effect of purpose in life, self-efficacy and social support on well-being and mental health, with partial mediation by appraisals and coping processes. Current stage of work: Data assessment is on-going. Discussion: Understanding the adjustment process following disability onset and identifying determinants of this process can support clinical decision making and contribute to the optimization of the rehabilitation process.